关键词: 结核, 抗多种药物性, 病例管理, 护理实践模式, 药物治疗依从性, 贝达喹啉

Abstract:

A total of 50 patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB), who received bedaquiline treatment in the Shanghai Pulmonary Hospital Affilicated to Tongji University from November 2018 to October 2019, were enrolled into this study. A individual case management model was used to all enrolled patients, and the medication adherence of those MDR-PTB patients was evaluated with the Morisky Medication Adherence Scale (MMAS, Chinese version) at 2 weeks, 1 month, 3 months and 6 months respectively after taking bedaquiline and their self-efficacy was evaluated with the General Self-efficacy Scale (GSE, Chinese version). The MMAS score of the patients was (5.25±0.15) before the intervention; after the intervention, it increased to (7.29±0.12), (7.68±0.07), (7.76±0.06) and (7.96±0.03) respectively at 2 weeks, 1 month, 3 months and 6 months of bedaquiline treatment, which was statistically significant higher than that before the intervention (F=88.925, P<0.001). The GSE score was (24.32±8.36) before the intervention; after the intervention, it was (25.20±7.94), (27.28±9.58), (36.48±5.81) and (36.76±5.90) respectively at 2 weeks, 1 month, 3 months and 6 months of bedaquiline treatment, which was statistically significant higher than that before the intervention (F=15.532, P<0.001). The study suggested that the application of the individual case management model in the management of MDR-PTB patients taking bedaquiline can significantly improve their treatment compliance and self-efficacy.

Key words: Tuberculosis, multidrug-resistant, Case management, Nursing practice model, Medication adherence, Bedaquiline